SA's new NSP

South Africa’s National Strategic Plan (NSP) for HIV, TB and STI’s 2017 – 2022, not surprisingly, dominated the June 15 closing plenary session of SA AIDS 2017. Dr Connie Kganaka, acting CEO of the SA National AIDS Council (SANAC), provided an overview of the eight goals of the NSP. She emphasised Goal 6, which focuses on promoting leadership and shared accountability for a sustainable response. This is a new inclusion in the NSP and attempts to foster a collective responsibility or “mutual accountability” across sectors and SANAC structures.

Goal 6 of the new NSP focusses on strengthening provincial and district-level SANAC structures where implementation is key. It also aims to strengthen the participation of civil society and the private sector, and to engage organised labour in the HIV response.Dr Fareed Abdullah, former SANAC CEO and recently-appointed head of the Office of AIDS and TB Research at the Medical Research Council (MRC), raised what he termed “missed opportunities” in the NSP. He pointed out that the NSP falls short on addressing prevention and that it is not possible to “treat our way out of the epidemic”. According to Abdullah the NSP toolbox does not match the prevention needs and nor does it adequately address the social- structure drivers of the epidemic. He proposed the establishment of a national prevention agency to coordinate implementation at community level. Abdullah went onto argue that the NSP has not given TB adequate attention and that TB should be considered and treated as a “national crisis”. This position was echoed by both Anele Yawa, the current General Secretary of the Treatment Actions Campaign (TAC) and Prof Glenda Gray of the MRC.Both Abdullah and Yawa considered the PrEP targets to be substantively conservative, with Yawa noting that the target had been reduced from 1.4 million in the early drafts to only 85,000 in the final NSP. Both pointed to the lack of strategy in relation to the legal reforms necessary in order to address the epidemic amongst key populations.Dr Aaron Motsoaledi, Minister of Health, acknowledged that there may be weaknesses in the plan and made a plea for cooperation during the implementation in order to address the missed opportunities.